AIM: To explore the histopathologic changes of Reis-Bücklers corneal dystrophy ( RBCD) . · METHODS: Cornea buttons were obtained from patients in 1 pedigree who underwent lamella keratoplasty. Sections with HE and special staining which included symplectic blue staining and Masson staining and Congo red staining were observed under light microscope. Two normal cornea specimens ( donated corneas from eye bank) were used as control. ·RESULTS:In those patients, the bowman's membrane disappeared. The main lesion was in bowman's membrane through HE staining, positive through PAS Congo red staining and Masson staining, negative through symplectic blue staining. ·CONCLUSION: The Reis-Bücklers corneal dystrophy is characterized as geographic map-like lesion of bowman's membrane, and the abnormal extracellular deposit is amyloid protein fiber.

AIM:To evaluate the short-term efficacy of posterior chamber phakic intraocular lens implantation for moderate to high myopia.METHODS:Fifty-three eyes of 27 patients with moderate to high myopia (-3.25 to-21.5D) were received posterior chamber phakic intraocular lens implantation with 2.8mm clear corneal incision.Changes of visual acuity, intraocular pressure(IOP), counts of endothelial cells and surgically induced astigmatism at 1mo after surgery were observed.RESULTS:The preoperative best corrected visual acuity (BCVA LogMAR) were 0.05±0.18, the postoperative BCVA at 1d were 0.02±0.14, the postoperative BCVA at 1wk were-0.05±0.11, the postoperative BCVA at 1mo were-0.07±0.10.The postoperative BCVA were statistically significant differences in different time(P<0.05).The preoperative endothelial cell count was 2932.5±270.8/mm2, the postoperative endothelial cell count at 1d was 2917.1±299.0/mm2;the postoperative endothelial cell count at 1wk was 2902.5±288.6/mm2;the postoperative endothelial cell count at 1mo was 2855.3±284.2/mm2.The postoperative endothelial cell count was not statistically significant differences in different time.The preoperative IOP was 15.8±2.5mmHg;the postoperative IOP at 1d was 15.3±2.9mmHg;the postoperative IOP at 1wk was 17.4±5.8mmHg;the postoperative IOP at 1mo were 15.8±2.6mmHg.The preoperative IOP was significantly different compared with postoperative IOP at 1d, 1wk and 1mo.The postoperative IOP at 1d and 1wk were statistically significant differences (P<0.05).The surgically induced astigmatism at 1d was 0.74±0.39D;the surgically induced astigmatism at 1wk was 0.57±0.28D;the surgically induced astigmatism at 1mo was 0.44±0.21D.The postoperative IOP were statistically significant differences in different time (P<0.05).The preoperative anterior chamber depth was 3.26±0.25mm;the postoperative central vault at 1d were 654.5±345.2μm;the postoperative central vault at 1mo were 683.0±211.7μm.The postoperative central vault were significantly different between that at 1d and 1mo after operations.Operations went without serious complications.CONCLUSION:Posterior chamber phakic intraocular lens implantation for moderate to high myopia were safe, effective and predictability.But long-term effect remains needed to be further follow-up.

OBJECTIVE: To investigate the prognosis of patients with vulnerable plaque indicated by coronary CT angiography (CCTA). METHODS: Totally 1963 patients underwent CCTA from February 2nd 2015 to September 13th 2015, and 2728 coronary borderline lesions (stenosis of 50%-70%) were detected. Among them 804 patients had vulnerable plaques and 1159 patients had stable plaques. The primary endpoint was major cardiac adverse events (MACE), including cardiac death, acute myocardial infarction and target lesion revascularization. RESULTS: Patients were followed up for a mean follow-up of 27.4±2.3 months. The incidence of MACE in the vulnerable plaque group was significantly higher than that in the stable plaque group (10.8%vs 2.3%, < 0.01). After adjusting for age, gender, smoking, hypertension, diabetes, hyperlipidemia, the MACE hazard ratio () in the vulnerable plaque group was 5.022 (95% :3.254-7.751, < 0.01).Subgroup analysis showed that in the vulnerable plaque group, the incidence of MACE in patients taking antiplatelet and statin ≤3 months and those taking antiplatelet and statin > 3 months was 17.0%and 5.8%, respectively (=3.149, 95% :1.987-4.992, < 0.01); but the difference did not seen in stable plaque group (=1.721, 95% :0.798-3.712, >0.05). CONCLUSIONS This study confirmed the risk of MACE in patients with vulnerable plaque detected by CCTA and the drug treatment may reduce the risk for patients with vulnerable plaque.
Computed Tomography Angiography ; Coronary Angiography ; Coronary Artery Disease ; diagnostic imaging ; Coronary Stenosis ; diagnostic imaging ; Humans ; Infant ; Plaque, Atherosclerotic ; diagnostic imaging ; pathology ; Prognosis ; Risk Factors

Aortic Valve/surgery* ; Aortic Valve Stenosis/surgery* ; Cardiac Catheterization ; Heart Rupture ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation ; Humans ; Transcatheter Aortic Valve Replacement/adverse effects* ; Treatment Outcome

BACKGROUNDTumor necrosis factor a receptor 1 (TNFalphaR1) plays an important role in the signal pathway of apoptosis. The objective of this study was to investigate the effects of TNFalphaR1 knockout on the up-regulation of erythropoietin receptor (Epo-R) and the coordinated anti-apoptosis functions during myocardial ischemia-reperfusion injury in mice.

METHODSThe ischemia-reperfusion injury model for cardiomyocytes was performed by ligating the left circumflex branch artery of TNFalphaR1 knockout (P55(-/-)) C17 B6 mice, as well as wild-type (P55(+/+)) C17 B6 mice. Triphenyltetrazolium chloride (TTC) staining was performed to observe the damaged area of the heart. TUNEL staining and DNA fragmentation were used to identify apoptosis. Mitochondrial Bcl-2 and Bax as well as expression of Epo-R and its downstream genes (Jak-2, stat-5, Akt, IkB-alpha, HIF-1alpha) were measured by Western blotting. The gene knockout mice were assigned into those undergoing the apoptosis surgical model group (KO group), and those subjected to sham operation (KOs group). Similarly, wild-type mice were either exposed to the surgical model (WT group) or subject to a sham operation (WTs group).

RESULTSThe myocardial damage ratio of the wild-type group after the operation was significantly higher than that of the knockout group, (50.5 +/- 6.4)% vs (36.9 +/- 6.9)%, P < 0.01. Similarly, TUNEL positive ratio of the wild-type group was significantly higher than that of the knockout group, (63.1 +/- 5.6)% vs (42.1 +/- 4.7)%, P < 0.01. The gray value ratios of Epo-R, Jak-2, stat-5, Akt, IkB-alpha, HIF-1 and mitochondrial Bcl-2 in the KO group were significantly higher than those of the WT group, P < 0.05; however, mitochondrial Bax was significantly lower than that of the WT group significantly (P < 0.05).

CONCLUSIONSUsing the ischemia-reperfusion injury model in mice, cardiomyocytes of TNFalphaR1 knockouts exhibited anti-apoptotic characteristics. This information could be used to coordinate the prevention of myocardial apoptosis by up-regulating and activating the Epo-R pathway.

Animals ; Apoptosis ; Blotting, Western ; Disease Models, Animal ; I-kappa B Proteins ; metabolism ; In Situ Nick-End Labeling ; In Vitro Techniques ; Janus Kinase 2 ; metabolism ; Male ; Mice ; Mice, Knockout ; Myocardial Reperfusion Injury ; genetics ; metabolism ; pathology ; Myocytes, Cardiac ; metabolism ; pathology ; NF-KappaB Inhibitor alpha ; Oncogene Protein v-akt ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Receptors, Erythropoietin ; metabolism ; Receptors, Tumor Necrosis Factor ; genetics ; metabolism ; STAT5 Transcription Factor ; metabolism ; Up-Regulation ; bcl-2-Associated X Protein ; metabolism

Objective: To investigate the sonographic features of primary thyroid lymphoma (PTL) and to evaluate the clinical significance of ultrasound-guided core needle biopsy (US-CNB) in PTL. Methods: A total of 24 patients with suspected PTL in Sir Run Run Shaw Hospital from January 2013 to June 2018 were analyzed retrospectively. All cases were confirmed by pathology, of them 23 patients received US-CNB and 1 patient chose operation without US-CNB, including 5 males and 19 females, aged from 39 to 75 years old. The effectiveness and safety of 23 patients with US-CNB were evaluated, and the sonographic features of 20 patients with PTL diagnosed by pathology were analyzed. Descriptive statistical methods were used in the study. Results: In the 23 patients with suspected PTL underwent US-CNB, 18 patients were diagnosed as PTL, 4 patients were respectively diagnosed as subacute thyroiditis, anaplastic carcinoma, Hashimoto's thyroiditis, and fibro thyroiditis, and the another patient was hard to diagnose by US-CNB and then was diagnosed as PTL by surgical biopsy. The success rate of US-CNB for diagnosis of PTL was 18/19, and no severe complications occurred in the patients with US-CNB. The other case was diagnosed as PTL by surgical biopsy without US-CNB. Sonographic features of 20 cases with PTL (18 cases diagnosed by US-CNB and 2 cases by surgery or surgery biopsy) were as follows: (1) Most nodules had irregular shapes and unsmooth margins; (2) Hypoechoic or markedly hypoechoic nodules with honeycombed or cord structures were observed in most cases; (3) Calcification was rare; (4) Multiple lesions were common; (5) Abundant intralesional vascularization was commonly observed; (6) Most cases had intensification of posterior acoustic enhancement; (7) Thyroid gland enlargement or with irregular shape; and (8) PTL often accompanied with lymph nodes enlargement in lateral neck or central region. Conclusion: PTL has certain sonographic features, with assistance of US-CNB, more accurate diagnosis of PTL can be obtained.
Adult ; Aged ; Biopsy, Large-Core Needle ; Female ; Humans ; Image-Guided Biopsy ; Lymphoma/diagnostic imaging* ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms/diagnostic imaging* ; Thyroid Nodule ; Ultrasonography, Interventional

OBJECTIVETo perform a meta-analysis on clinical outcomes of minimally invasive percutaneous plate osteosynthesis (MIPPO) or open reduction and internal fixation (ORIF) for distal tibial fractures in adults.

METHODSPubmed database (from 1968 to March 2014), Cochrane library and CNKI database (from 1998 to March 2014) were searched. Case-control study on minimally invasive percutaneous plate osteosynthesis (MIPPO) or open reduction and internal fixation (ORIF) for distal tibial fractures in adults were chosen,and postoperative infection, operative time, blood loss, fracture nonunion rate, delayed union,fracture malunion rate were seen as evaluation index for meta analysis. The system review was performed using the method recommended by the Cochrane Collaboration.

RESULTSTotally 5 studies (366 patients) were enrolled. Meta-analysis showed that there were significant meaning in postoperative infection between MIPPO and ORIF [OR = 0.23,95% CI (0.06,0.92), P = 0.04]; fracture nonunion rate in MIPPO was lower than in ORIF group [OR = 0.16, 95% CI (0.03,0.76), P = 0.02]; operative time in MIPPO was shorter than in ORIF group, and had significant difference [MD = -14.42, 95% CI (-27.79, -1.05), P < 0.05]; blood loss in MIPPO was less than in ORIF group [MD= -87.17,95%CI (-99.20, -75.15), P < 0.05]; there was no obviously meaning in delayed union between two groups.

CONCLUSIONFor distal tibial fractures in adults, MIPPO has, advantages of short operative time, less blood loss, lower incidence of infection and fracture non-uniom, but with high fracture malunion rate. MIPPO for distal tibial fractures in adults is better than ORIF, and the best treatment should choose according to patient's condition.

Bone Plates ; Fracture Fixation, Internal ; methods ; Fracture Healing ; Humans ; Minimally Invasive Surgical Procedures ; methods ; Operative Time ; Tibial Fractures ; surgery

BACKGROUND: Many data demonstrate that the components of soybean can lower blood lipid,suppress the growth of cancer cells and exert weak estrogenic activities. However,little is known about the effect of isolated soybean protein on the lifespan of the organism.OBJECTIVE: To observe the effect of isolated soybean protein on the lifespan of drosophila melanogasters and investigate the mechanism of effective anti-aging and anti-oxidation action.DESIGN: A controlled trial based on drosophila melanogasters.SETTING: Department of nutrition and food hygiene in a university.MATERIALS: The experiment was conducted in the Department of Nutrition and Food Hygiene,Public Health College of Xinjiang Medical University from March to June 2002. A total of 400 drosophila melanogasters of American wild type with half for each gender were provided by the Department of Nutrition and Food Hygiene, Public Health College of Xinjiang Medical University.METHODS: The 400 drosophila melanogasters were divided into control group(normal culture) and three-dosage experiment groups(normal culture contained isolated soybean protein 0.2%,1.0% and 5.0%,respectively).From the second day on, the number of living and dead drosophila melanogasters was observed and counted until all died. Meanwhile, mean lifespan,half death time and maximal lifespan were calculated.MAIN OUTCOME MEASURFS: Mean lifespan, half death time and maximal lifespan of the drosophila melanogasters.RESULTS: Compared with that of control group, the lifespan of male and female drosophila melanogasters in experiment groups was prolonged by isolated soybean protein and responded in a dose-dependent manner,especially in high-dosage group. The mean lifespan, half death time and maximal lifespan of both female and male drosophila melanogasters were prolonged by 24.5% and20.7%,27.1% and22.0%,and 13.9% and 10.6%,respectively.CONCLUSION: Isolated soybean protein may have anti-aging and lifespan-prolonging effects on drosophila melanogasters.

Objective To evaluate the feasibility and initial experience of laparoscopic pyelolithoto- my within renal sinus.Methods A total of 19 patients(14 men and 5 women)of nephrolithiasis on 21 sides underwent laparoscopic pyelolithotomy within renal sinus.Of them,9 cases with other upper urinary tract diseases were treated by laparoseopic pyelolithotomy at the same time.The patient age ranged from 16 to 67 years(mean,41 years).The calculi were 1.2 to 3.5 cm in diameter,and were found on the right side in 11 cases,left side in 6,and both sides in 2.Five cases concomitantly had ureteral calculi;of them,1 had bi- lateral ureter calculi with ipsilateral steinstrasse,2 had pyelic polyp(1 with giant hydronephrosis after open ureterolithotomy),and 1 had giant bydronephrosis with pyelolithiasis during pregnancy with double-J tube drainage.Twelve cases(13 sides)had experienced unsuccessful extracorporeal shock wave lithotripsy,and 1 failed with minimally invasive percutaneous nephrolithotomy.Results The procedure was successful in all the 19 cases.The operative time ranged from 75 to 240 rain(mean,115 rain).The intraoperative blood loss ranged from 30 to 100ml(mean,50 ml).One case experienced 5-d urine leakage,and was spontaneously cured.The hospital stay was 5-9 d(mean,6 d).Double-J tube drainage was 4-6 weeks.During the follow- up(3-36 months),KUB and IVU showed no upper urinary tract stricture and no residual stones except for 1 stone of 0.7 cm in the renal lower calyx in 1 case.The kidney function was improved in all cases.Con- clusions Laparoscopic pyelolithotomy is new and minimally invasive alternative approach for renal calculi. With this procedure the urinary tract complications can be treated concomitantly,thus it can partially replace open surgery.

To analyze dryeye disease after the femtosecond laser and mechanical microkeratome for laser in situ keratomileusis ( LASlK ) by Oculus dry eye analyzer examination.METHODS: The people who had femtosecond LASlK ( FS-LASlK ) and mechanical microkeratome LASlK in Weifang Eye Hospital from January 2014 to April 2014 were observed. Sixty patients ( 120 eyes ) who had corneal refractive surgery were collected. The average age of patients was 27. 46 ± 6. 65 years old. The LASlK group had 28 patients ( 56 eyes ) and the FS-LASlK group had 32 patients ( 64 eyes ) . The tears river altitude, first tear break up time ( BUT) , and average BUT at preoperative, 1wk and 1mo after operation were observed by Oculus dry eye analyzer.RESULTS:By Oculus dry eye analyzer examination, the preoperative tears river altitude of patients was 0. 25 ± 0. 10mm. First BUT was 6. 70 ± 3. 86s. Average BUT time was 10. 14 ± 4. 51s. At 1wk after operation, the tears river altitude of patients was 0. 19±0. 04mm. The first BUT time was 4.87±1.71s. The average BUT time was 7.77±2.30s. There was significant difference between preoperative and 1wk after operation (P<0. 05). At 1mo after operation in two groups, the tears river altitude of patients was 0. 19 ± 0. 18mm . The average BUT 8. 72 ± 2. 54s. The BUT was 5. 02 ± 2. 30s. There was significant difference between preoperative and 1mo after operation (P<0. 05). The two groups had significant difference in average tears river altitude and average BUT between 1mo and 1wk after operation. There was no significant difference in the first BUT between 1mo and 1wk after operation. There was no significant difference between LASlK and FS - LASlK groups at any time of the test (P<0. 05).CONCLUSlON: LASlK and FS - LASlK patients have different degree of dry eye symptom after operation. Dry eye symptoms mainly display in the decrease of tear production and the stability of tear film. lt will be better after giving artificial tears. Oculus dry eye analyzer is a non-invasive examination equipment. lt can reflect the amount of tears and the stability of tear film. lt is usefull in rapid diagnosis of dry eye and judgment of the degree of dry eye symptom after LASlK operation.